Non-linear price schedules, demand for health care and response behavior
AbstractWhen health insurance reforms involve non-linear price schedules tied to payment periods (for example, a quarter or a year), the empirical analysis of its effects has to take the within-period time structure of incentives into account. The analysis is further complicated when demand data are obtained from a survey in which the reporting period does not coincide with the payment period. We illustrate these issues using as an example a health care reform in Germany which imposed a perquarter fee of e10 for doctor visits and additionally set an out-of-pocket maximum. This co-payment structure results in an effective "spot" price for a doctor visit which decreases over time within each payment period. Using this variation, we find a substantial effect of the new fee, in contrast to earlier studies of this reform. Overall, the probability of visiting a physician decreased by around 2.5 percentage points in response to the new fee for doctor visits. We verify the key assumptions of our approach using a separate data set of insurance claims in which the reporting period effects are absent by construction.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 12/15.
Date of creation: Jul 2012
Date of revision:
Contact details of provider:
Postal: HEDG/HERC, Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom
Phone: (0)1904 323776
Fax: (0)1904 323759
Web page: http://www.york.ac.uk/res/herc/research/hedg/
More information through EDIRC
health economics; non-linear pricing; response behavior; natural experiment;
Find related papers by JEL classification:
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
- D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
This paper has been announced in the following NEP Reports:
- NEP-ALL-2012-09-30 (All new papers)
- NEP-COM-2012-09-30 (Industrial Competition)
- NEP-HEA-2012-09-30 (Health Economics)
- NEP-IAS-2012-09-30 (Insurance Economics)
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Jonas Schreyögg & Markus Grabka, 2010.
"Copayments for ambulatory care in Germany: a natural experiment using a difference-in-difference approach,"
The European Journal of Health Economics,
Springer, vol. 11(3), pages 331-341, June.
- Schreyögg, Jonas & Grabka, Markus M., 2010. "Copayments for Ambulatory Care in Germany: A Natural Experiment Using a Difference-in-Difference Approach," EconStor Open Access Articles, ZBW - German National Library of Economics.
- Jonas Schreyögg & Markus M. Grabka, 2008. "Copayments for Ambulatory Care in Germany: A Natural Experiment Using a Difference-in-Difference Approach," SOEPpapers on Multidisciplinary Panel Data Research 96, DIW Berlin, The German Socio-Economic Panel (SOEP).
- Jonas Schreyögg & Markus M. Grabka, 2008. "Copayments for Ambulatory Care in Germany: A Natural Experiment Using a Difference-in-Difference Approach," Discussion Papers of DIW Berlin 777, DIW Berlin, German Institute for Economic Research.
- Schreyoegg, Jonas & Grabka, Markus M, 2008. "Copayments for Ambulatory Care in Germany: A Natural Experiment Using a Difference-in-Difference Approach," MPRA Paper 23035, University Library of Munich, Germany.
- Rainer Winkelmann, 2004.
"Co-payments for prescription drugs and the demand for doctor visits - Evidence from a natural experiment,"
John Wiley & Sons, Ltd., vol. 13(11), pages 1081-1089.
- Rainer Winkelmann, 2003. "Co-Payments for Prescription Drugs and the Demand for Doctor Visits - Evidence from a Natural Experiment," Working Papers 0307, University of Zurich, Socioeconomic Institute.
- Boris Augurzky & Thomas Bauer & Sandra Schaffner, 2006. "Copayments in the German Health System – Do They Work?," RWI Discussion Papers 0043, Rheinisch-Westfälisches Institut für Wirtschaftsforschung.
- Winkelmann, Rainer, 2006. "Reforming health care: Evidence from quantile regressions for counts," Journal of Health Economics, Elsevier, vol. 25(1), pages 131-145, January.
- Amanda E. Kowalski, 2009. "Censored Quantile Instrumental Variable Estimates of the Price Elasticity of Expenditure on Medical Care," NBER Working Papers 15085, National Bureau of Economic Research, Inc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Jane Rawlings).
If references are entirely missing, you can add them using this form.